An UNDO Project
Last Updated: 9/23/2024
Man in dark background with smoke around his faceMan in dark background with smoke around face

Rural Communities

How Big Tobacco Targets Rural Communities

Rural communities are full of hardworking people who value strength and independence. Tobacco companies understand this, so they package and advertise their deadly products to play to values of self-reliance and resiliency with images such as cowboys, hunters, and racecar drivers. Big Tobacco aggressively markets cigarettes and smokeless tobacco products like chew in rural areas, taking advantage of weaker tobacco retail licensing laws in rural communities.1 This has contributed to increased smokeless tobacco use rates among high school males in rural areas, exceeding the national average.2

Because of these practices, rural counties have some of the highest smoking rates in California,3 and rural residents start smoking at an earlier age.4 Rural counties also suffer higher rates of lung cancer,5 and smoking causes 80-90 percent of lung cancer cases. That’s why it’s more important than ever to ensure rural communities are truly free from Big Tobacco’s deadly, addictive products.

The proof is in the data

[Data last updated September 2024]
Indicator
Rural Communities
General Population
Adult tobacco use
1. Adult cigarette use: Adult cigarette smoking prevalence
9.1%
The estimate is significantly higher than the California general population.
6.1%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
2. Change in Adult Cigarette Use: Rate of change in adult cigarette smoking, 2014 to 2022
-34.1%
The 2022 estimate is significantly lower than the 2014 estimate.
-50.8%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
  • California Health Interview Survey, 2013-14. Los Angeles, CA: UCLA Center for Health Policy Research.
3. Adult tobacco use: Adult tobacco use prevalence (e.g. cigarettes, e-cigarettes and other vaping products, other tobacco products)
15.1%
The estimate is significantly higher than the California general population.
11.4%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
Youth Tobacco Use
4. Youth cigarette use: Youth cigarette smoking prevalence
1.9%
1.2%
  • California Youth Tobacco Survey, 2023. RTI International.
5. Youth tobacco use: Youth tobacco use prevalence (e.g. cigarettes, e-cigarettes and other vaping products, other tobacco products)
9.6%
The estimate is significantly higher than the California general population.
7.3%
  • California Youth Tobacco Survey, 2023. RTI International.
Availability of tobacco & tobacco industry influence
6. Cheapest cigarettes: Average price for the cheapest pack of cigarettes
$7.02
$7.11
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
7. Flavored little cigar price: Average price for a single flavored little cigar/cigarillo
$0.97
$0.97
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
8. Tobacco stores: Density of stores selling tobacco per 100,000 residents
90.6
The estimate is 10.0 stores per 100,000 higher than the California general population.
74.8
  • California Cigarette and Tobacco Products Retailer Licensees, March 29, 2024. Sacramento, CA: California Department of Tax and Fee Administration.
  • American Community Survey, 2018-2022. Suitland, MD: U.S. Census Bureau.
  • Cartographic Boundaries, 2020. Suitland, MD: U.S. Census Bureau.
9. Flavored tobacco: Proportion of stores that sell flavored non-cigarette tobacco products
86.6%
The estimate is significantly higher than the California general population.
81.8%
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
10. Menthol cigarettes: Proportion of stores that sell menthol cigarettes
92.4%
The estimate is significantly higher than the California general population.
88.3%
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
11. Tobacco advertising: Proportion of stores that keep 90% of their storefront free from any advertising
39.5%
40.1%
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
Secondhand smoke
12. Adult secondhand tobacco exposure: Proportion of adults exposed to secondhand smoke or vape
26.3%
24.5%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
13. Youth secondhand tobacco exposure: Proportion of youth exposed to secondhand smoke or vape
15.0%
The estimate is significantly lower than the California general population.
32.9%
  • California Youth Tobacco Survey, 2023. RTI International.
14. Smoke-free homes: Proportion of adults with smoke-free homes
91.1%
90.9%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
Cessation
15. Quitting: Proportion of smokers who tried quitting in the last 12 months
55.4%
57.9%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
16. Doctor advice to quit: Proportion of smokers whose doctors advised them to quit
53.3%
49.1%
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.
  • California Health Interview Survey, 2021-22. Los Angeles, CA: UCLA Center for Health Policy Research.

Organizations around the state are working to fix tobacco-related health disparities.

Find out more about what each organization is doing to fight the tobacco industry's predatory tactics.
The American Cancer Society Cancer Action Network

ACS CAN Central Valley Regional Rural Initiative to Reduce Tobacco-Related Disparities

The American Cancer Society Cancer Action Network (ACS CAN) is the nation’s leading cancer advocacy organization and the nonprofit. The Central Valley Regional Initiative of the ACS CAN works to reduce tobacco-related health disparities in rural communities in the Central Valley region to create more smoke-free environments across multi-unit housing complexes, healthcare campuses, and community colleges and trade schools, including in Kings, Madera, Mariposa, Merced, and Tulare counties.

California Health Collaborative - Chico

Statewide Coordinating Center for Rural Communities

The Rural Communities Coordinating Center is a joint partnership between the California Health Collaborative (CHC) and Education, Training and Research (ETR) project that provides support and assistance to California’s five rural regional projects. The Rural Communities Coordinating Center aims to inform and educate policy makers, community members, and key stakeholders about a Rural Communities Policy Platform to prevent and reduce tobacco use among California’s rural communities. Further, the Coordinating Center will build mindshare within the rural communities to engage in tobacco prevention policy advocacy with non-traditional partners such as law enforcement, tribal stakeholders, and environmental groups.

Del Norte County

North Coast Regional Partnership

This project addresses tobacco-related health disparities in rural populations by building community awareness and support for proven tobacco control strategies in the rural North Coast Region of California, including advancing Tobacco Retail Licensing policies, advancing Smoke-Free Multi-Unit Housing policies, advancing smoke-free fairgrounds, and casino policies.

American Lung Association in California, Chico Office

North Valley Region

This project focuses on engaging communities in the North Valley Region (Butte, Glenn, Shasta, Colusa, Tehama, and Yuba counties) to address tobacco-related health disparities. We work small, rural communities to encourage local celebrations, festivals, parades, or other heritage community events to implement voluntary smoke-free policies, as well as other community organizations, educational campuses, licensed health care and assisted living facilities, as well as improve referrals to the California Smokers’ Helpline and reduce exposure to secondhand smoke and aerosol.

California Health Collaborative - Chico

Gold Country Region Rural Initiative

The California Health Collaborative’s Gold Country Rural Regional Initiative focuses on the six most rural counties of the region including Sutter, Stanislaus, El Dorado, Amador, Tuolumne, and Nevada to reduce exposure to secondhand smoke and tobacco use. We work to ensure that tobacco control policies are included in City/County General Plans, and at community colleges and trade schools. We also work to mobilize young adults to provide education on secondhand smoke, smokeless tobacco, electronic smoking devices, and tobacco industry targeting of priority populations for policymakers and other community stakeholders.

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A Story of Inequity

Tobacco’s impact on health disparities in California

For decades, the tobacco industry has aggressively targeted California’s diverse communities with predatory practices. Internal documents from Big Tobacco outline their strategies – many of which are shocking attempts to peddle deadly products by way of product discounts and manipulative advertising. They even gave away free products to youth in the past. These tactics masquerade as support for communities under the guise of cultural celebration.

Unfortunately, the tactics have worked. Big Tobacco aggressively targeted communities and, as a result, some populations have higher rates of tobacco use, experience greater secondhand smoke exposure at work and at home, and have higher rates of tobacco-related disease than the general population.1

Addressing tobacco-related health inequities is key to California’s efforts to fight tobacco, our state’s number one cause of preventable death and disease.2 Tobacco use, pricing, and its impact across California were analyzed where significant disparities were found across various populations. See how Big Tobacco affects each community in the Nation’s most diverse state.

A Story Of Inequity methodology >